CAJ | 학술논문

目的总结手术治疗动脉瘤的经验。方法回顾性总结外科治疗的500例Ⅰ～Ⅴ级颅内动脉瘤患者的临床资料，包括动脉瘤的分级、手术时机的选择、控制性低血压麻醉、脑保护剂与载瘤动脉暂时阻断结合应用、经颅多普勒超声动态监测、脑血管痉挛治疗、直接手术中动脉瘤处理技术、血管内动脉瘤栓塞。结果 465例Ⅰ～Ⅳ级颅内动脉瘤患者的手术病死率为2.7%,1990年前手术的210例病死率为3.8%；1990年后手术的255例病死率为1.9%。35例动脉瘤栓塞的患者无死亡。结论对颅内动脉瘤采取外科综合治疗措施能有效的改善患者的预后。
목적총결수술치료동맥류적경험。방법회고성총결외과치료적500례Ⅰ～Ⅴ급로내동맥류환자적림상자료，포괄동맥류적분급、수술시궤적선택、공제성저혈압마취、뇌보호제여재류동맥잠시조단결합응용、경로다보륵초성동태감측、뇌혈관경련치료、직접수술중동맥류처리기술、혈관내동맥류전새。결과 465례Ⅰ～Ⅳ급로내동맥류환자적수술병사솔위2.7%,1990년전수술적210례병사솔위3.8%；1990년후수술적255례병사솔위1.9%。35례동맥류전새적환자무사망。결론대로내동맥류채취외과종합치료조시능유효적개선환자적예후。
Objective　To summarize the experience in improving the surgical results of patients with aneurysms.　Methods　We retrospectively reviewed the data on the treatment of 500 patients in terms of timing of surgery, induced-hypotensive anesthesia, brain protection combined with temporal occlusion of feeding artery of aneurysm, dynamically monitoring of transcranial Doppler ultrasound, anti-vasospasm treatment, techniques of direct surgery and endovascular embolization of aneurysms.　Results　465 patients underwent surgery. Intraoperative rupture was seen in 27 patients (6.2%), postoperative death in 13 (2.7%), hemipalsy in 8(2.2%) and vegitative state in 2 (5.0%). The operative mortality was 3.8%in 210 patients before 1990 and 1.9% in 255 patients after 1990.　Conclusion　The outcome of intracranial aneurysm can be effectively improved by comprehensive measures as shown in our 500 patients.